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Risk of opportunistic infections in patients treated with alemtuzumab for multiple sclerosis
- Source :
- Expert Opinion on Drug Safety. 17:709-717
- Publication Year :
- 2018
- Publisher :
- Informa UK Limited, 2018.
-
Abstract
- Alemtuzumab is a monoclonal anti CD-52 antibody recently approved for use in relapsing-remitting multiple sclerosis(MS). Given that the targeted antigen is primarily expressed on B and T lymphocytes, the administration of this biological drug is associated with rapid but protracted peripheral lymphopenia.The impact on infective risk of this immune impairment is still to be fully understood. In this review, we attempt to summarize all the available literature concerning opportunistic infections occurring in patients with MS receiving alemtuzumab. Infective adverse events were observed in more than 70% of patients in phase 2/3 RCTs, mainly of mild-to-moderate severity. Nevertheless, several post-marketing reports documented cases of serious, rare, and unexpected infections.Predictive risk factors and prognostic features of opportunistic infections in this setting still need to be exactly assessed. At present, the only recommended preventive measures consist in anti-herpetic prophylaxis, Listeria-free diet, Tuberculosis prophylaxis and annual Papillomavirus screening. Given the non-negligible risk of unpredicted infective events, we advise physicians to take into account patients' history of infectious diseases and vaccine status and to consider supplementary prophylactic strategies, including screening for Toxoplasma gondii and viral hepatitis serostatus as well as pre-emptive approaches to avert CMV reactivation and Pneumocystosis.
- Subjects :
- 0301 basic medicine
Drug
medicine.medical_specialty
Prognosi
medicine.drug_class
media_common.quotation_subject
Opportunistic Infection
030106 microbiology
Opportunistic Infections
Monoclonal antibody
Severity of Illness Index
03 medical and health sciences
Multiple Sclerosis, Relapsing-Remitting
0302 clinical medicine
Antigen
Risk Factors
Internal medicine
RRMS
Product Surveillance, Postmarketing
medicine
Humans
Pharmacology (medical)
Prophylaxi
Adverse effect
monoclonal antibodie
Alemtuzumab
Anti CD-52
Randomized Controlled Trials as Topic
media_common
biology
business.industry
Risk Factor
Multiple sclerosis
General Medicine
Prognosis
medicine.disease
Monoclonal
biology.protein
Antibody
business
biological therapie
030217 neurology & neurosurgery
Human
medicine.drug
Subjects
Details
- ISSN :
- 1744764X and 14740338
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Expert Opinion on Drug Safety
- Accession number :
- edsair.doi.dedup.....ee98656428d9cfe038c6edca5c71546e